Fertility Journeys Can Feel Isolating — Here’s Why Support Matters

Fertility treatment is often described in terms of medications, procedures and timelines, but for many patients, the emotional impact can be just as overwhelming as the physical process itself. Studies have shown that people undergoing fertility treatment experience significantly higher rates of anxiety and depression than the general population, yet many continue to suffer quietly without seeking mental health support. Feelings of shame, uncertainty, isolation and pressure to “stay positive” can make an already difficult journey feel even heavier.

According to Esther Chung, M.D., OB-GYN and fertility specialist at HRC Fertility, fertility care is still too often centered on clinical outcomes while the emotional realities remain underdiscussed. Patients may spend months or years balancing hope and disappointment, all while continuing to show up for work, relationships and daily responsibilities as though nothing is happening behind the scenes. Chung says that invisibility can make infertility feel especially isolating.

In this Q&A, Chung discusses why so many patients struggle in silence, how support systems can shape the fertility journey, what the medical community still needs to improve when it comes to emotional care and why younger adults should begin thinking about fertility education earlier than many realize.

Reports show that both men and women experience higher rates of anxiety and depression during fertility treatments than the general population, yet fewer than 7% of those struggling seek psychiatric help. From what you see in your practice every day, why do you think so many people going through one of the most emotionally intense experiences of their lives are still suffering in silence?

Esther Chung, M.D.: In my experience, it’s a combination of stigma, isolation and the way fertility treatment is structured. There’s still a deeply ingrained belief that fertility should be “natural,” so when people need help, they often internalize it as a personal failure. That creates shame, which keeps people quiet.

At the same time, fertility treatment is incredibly medicalized (appointments, lab results, medications), but the emotional side is often underaddressed. Patients can feel like they’re expected to just “be strong and keep going,” especially because treatment is time-sensitive.

There’s also a kind of silent culture around infertility. Many patients don’t share what they’re going through even with close friends or family, either to avoid questions or to protect themselves from disappointment if things don’t work. Without that openness, it’s easy to feel like you’re the only one struggling, even though it’s actually very common.

As both a clinician and a former patient yourself, how would you describe what the fertility journey really does to a person psychologically, and what surprised you most when you experienced it firsthand?

EC: Psychologically, fertility treatment can become all-consuming. It shifts how you think about your body, from something you trust and know better than anyone else to something you’re constantly evaluating and wondering, is it working? Cycles, outcomes and timelines become a source of stress rather than something routine.

What surprised me most was how persistent the uncertainty feels. Even as a physician who understands the science and probabilities, experiencing it personally is very different. There’s a constant tension between hope and guardedness, and that emotional oscillation can be exhausting.

I was also struck by how invisible the experience is. You can go through something incredibly intense, physically and emotionally, and still show up to work, social events or daily life as if nothing is happening. That disconnect can make the experience feel even more isolating.

How much does the quality of someone’s support system actually affect their outcomes, and what can patients do if they feel like they are navigating this largely alone?

EC: A strong support system doesn’t necessarily change clinical outcomes, but it can significantly change how a patient experiences the journey, and that matters. Patients who feel supported often cope better with uncertainty, setbacks and the cumulative stress of treatment.

Support doesn’t have to be large to be meaningful. Even one person who truly understands and is willing to listen without trying to “fix” things can make the biggest difference.

For patients who feel alone, I encourage them to be intentional about building support in alternative ways. That might mean connecting with a therapist who specializes in fertility, joining support groups (in person or virtual), or even engaging with vetted online communities. It can also help to be explicit with friends or partners about what kind of support is actually helpful, whether that’s distraction, presence or simply acknowledgment.

How did your personal experience change the way you show up for your patients, and what do you think the medical community needs to do better in terms of supporting the mental health of the providers doing this work?

EC: My experience made me more attuned to the emotional undercurrent of every visit. I’m more mindful of how I deliver information, how patients might interpret uncertainty and how much weight even small updates can carry.

It also reinforced for me that emotional care is not separate from clinical care, it’s part of it. Sometimes that means pausing to acknowledge how hard something is, even if the treatment plan itself hasn’t changed.

For the medical community, we need to better recognize that providers in this space are also absorbing a significant emotional load. Fertility care involves walking with patients through repeated hope and loss, and that can take a toll over time.

Simply normalizing conversations about burnout and creating recovery outlets and spaces for burnout need to be integrated into the field. Supporting providers ultimately improves the care patients receive.

For someone in their 20s or early 30s who is not actively trying to conceive but knows they want children someday, what does meaningful fertility education and planning look like?

EC: Meaningful fertility education starts with understanding that fertility is not static over time. Age is still the most significant factor affecting both egg quality and quantity, but many people don’t receive clear, actionable information about what that means for them personally.

Planning doesn’t necessarily mean taking immediate action. It means being informed enough to make decisions aligned with your goals. For some, that might include a baseline fertility assessment, like ovarian reserve testing or a consultation to understand timelines. For others, it might involve considering options like egg freezing, depending on personal priorities.

Equally important is understanding that fertility is influenced by both partners and by overall health factors. Taking a proactive approach early gives people more flexibility and reduces the pressure of making decisions under time constraints later.